JAMA neurology最新文献

{"title":"Cognitive Effects of MR-Guided Focused Ultrasound Thalamotomy-Time to Evaluation-Reply.","authors":"Michael G Kaplitt, Vibhor Krishna, Howard M Eisenberg","doi":"10.1001/jamaneurol.2024.4788","DOIUrl":"10.1001/jamaneurol.2024.4788","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"309-310"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apixaban to Prevent Covert Infarcts After Cryptogenic Stroke in Patients With Atrial Cardiopathy: A Secondary Analysis of the ARCADIA Randomized Clinical Trial.","authors":"Maarten G Lansberg, Max Wintermark, Hui Chen, George Howard, Christy Cassarly, Qi Pauls, Stephanie Kemp, Tashia L Harris, Balaji Krishnaiah, Robert J Stanton, Michael J Lyerly, Benjamin R Miller, Eric E Smith, David L Tirschwell, Kevin N Sheth, Hooman Kamel, William T Longstreth, Mitchell S V Elkind, Joseph P Broderick, Ronald M Lazar","doi":"10.1001/jamaneurol.2024.4838","DOIUrl":"10.1001/jamaneurol.2024.4838","url":null,"abstract":"<p><strong>Importance: </strong>In the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) randomized clinical trial, anticoagulation did not prevent recurrent stroke among patients with a recent cryptogenic stroke and atrial cardiopathy. It is unknown whether anticoagulation prevents covert infarcts in this population.</p><p><strong>Objective: </strong>To test the use of apixaban vs aspirin for prevention of nonlacunar covert infarcts after cryptogenic stroke in patients with atrial cardiopathy.</p><p><strong>Design, setting, and participants: </strong>ARCADIA-MRI, an ancillary study to the ARCADIA trial with a median follow-up period of 27 months, enrolled participants from 75 sites in the US from November 14, 2019, until December 2, 2022. Participants in ARCADIA were invited to coenroll in ARCADIA-MRI if they had not permanently discontinued the study drug and had no contraindications on magnetic resonance imaging (MRI). A total of 310 (31%) of the 1015 ARCADIA participants enrolled in ARCADIA-MRI and of those 174 (56%) with adequate quality baseline and follow-up MRI were included in the present analyses.</p><p><strong>Interventions: </strong>MRI performed at the time of the index stroke served as the baseline image unless it was unavailable or of insufficient quality, in which case a new research MRI was obtained. A follow-up research MRI was performed upon each participant's completion of participation in the ARCADIA parent study.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was incident nonlacunar covert infarct on the follow-up MRI assessed by 2 independent raters who were masked to treatment assignment.</p><p><strong>Results: </strong>Baseline characteristics were balanced between the apixaban (n = 79) and aspirin (n = 95) arms. The mean (SD) age was 66 (10.6) years, and the median (IQR) modified Rankin Scale (mRS) score 1 (0-2). Ninety-one participants (52.3%) were male. During the median (IQR) follow-up of 811 (487-1288) days, the risk of incident nonlacunar covert infarcts was lower in the apixaban group (5.1%) than the aspirin group (17.9%) (weighted relative risk, 0.29; 95% CI, 0.10-0.83).</p><p><strong>Conclusions and relevance: </strong>Apixaban compared to aspirin was associated with fewer incident nonlacunar covert infarcts among a subset of patients with a recent cryptogenic ischemic stroke and atrial cardiopathy who were enrolled in ARCADIA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03192215.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"220-227"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Really Itching?-Reply.","authors":"Rafi Hadad","doi":"10.1001/jamaneurol.2024.4833","DOIUrl":"10.1001/jamaneurol.2024.4833","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"311"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equipping AI for Unbiased and Inclusive Neurology.","authors":"Nina F Schor","doi":"10.1001/jamaneurol.2024.3954","DOIUrl":"10.1001/jamaneurol.2024.3954","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"211-212"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Individual Pain Sensitivity Using a Novel Cortical Biomarker Signature.","authors":"Nahian S Chowdhury, Chuan Bi, Andrew J Furman, Alan K I Chiang, Patrick Skippen, Emily Si, Samantha K Millard, Sarah M Margerison, Darrah Spies, Michael L Keaser, Joyce T Da Silva, Shuo Chen, Siobhan M Schabrun, David A Seminowicz","doi":"10.1001/jamaneurol.2024.4857","DOIUrl":"10.1001/jamaneurol.2024.4857","url":null,"abstract":"<p><strong>Importance: </strong>Biomarkers would greatly assist decision-making in the diagnosis, prevention, and treatment of chronic pain.</p><p><strong>Objective: </strong>To undertake analytical validation of a sensorimotor cortical biomarker signature for pain consisting of 2 measures: sensorimotor peak alpha frequency (PAF) and corticomotor excitability (CME).</p><p><strong>Design, setting, and participants: </strong>This cohort study at a single center (Neuroscience Research Australia) recruited participants from November 2020 to October 2022 through notices placed online and at universities across Australia. Participants were healthy adults aged 18 to 44 years with no history of chronic pain or a neurological or psychiatric condition. Participants experienced a model of prolonged temporomandibular pain with outcomes collected over 30 days. Electroencephalography to assess PAF and transcranial magnetic stimulation (TMS) to assess CME were recorded on days 0, 2, and 5. Pain was assessed twice daily from days 1 through 30.</p><p><strong>Exposure: </strong>Participants received an injection of nerve growth factor (NGF) to the right masseter muscle on days 0 and 2 to induce prolonged temporomandibular pain lasting up to 4 weeks.</p><p><strong>Main outcomes and measures: </strong>The predictive accuracy of the PAF/CME biomarker signature was determined using a nested control-test scheme: machine learning models were run on a training set (n = 100), where PAF and CME were predictors and pain sensitivity was the outcome. The winning classifier was assessed on a test set (n = 50) comparing the predicted pain labels against the true labels.</p><p><strong>Results: </strong>Among the final sample of 150 participants, 66 were female and 84 were male; the mean (SD) age was 25.1 (6.2) years. The winning classifier was logistic regression, with an outstanding area under the curve (AUC = 1.00). The locked model assessed on the test set had excellent performance (AUC = 0.88; 95% CI, 0.78-0.99). Results were reproduced across a range of methodological parameters. Moreover, inclusion of sex and pain catastrophizing as covariates did not improve model performance, suggesting the model including biomarkers only was more robust. PAF and CME biomarkers showed good to excellent test-retest reliability.</p><p><strong>Conclusions and relevance: </strong>This study provides evidence for a sensorimotor cortical biomarker signature for pain sensitivity. The combination of accuracy, reproducibility, and reliability suggests the PAF/CME biomarker signature has substantial potential for clinical translation, including predicting the transition from acute to chronic pain.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"237-246"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation in ESUS-Back From the Dead?","authors":"Holly Elser, S Andrew Josephson","doi":"10.1001/jamaneurol.2024.4847","DOIUrl":"10.1001/jamaneurol.2024.4847","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"214-215"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors in the Title, Short Title, and Additional Contributions.","authors":"","doi":"10.1001/jamaneurol.2024.4924","DOIUrl":"10.1001/jamaneurol.2024.4924","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"311"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Results With Patisiran for Hereditary Transthyretin Amyloidosis With Polyneuropathy: A Randomized Clinical Trial With Open-Label Extension.","authors":"David Adams, Jonas Wixner, Michael Polydefkis, John L Berk, Isabel M Conceição, Angela Dispenzieri, Amanda Peltier, Mitsuharu Ueda, Shaun Bender, Kelley Capocelli, Patrick Y Jay, Elena Yureneva, Laura Obici","doi":"10.1001/jamaneurol.2024.4631","DOIUrl":"10.1001/jamaneurol.2024.4631","url":null,"abstract":"<p><strong>Importance: </strong>There is a lack of long-term efficacy and safety data on hereditary transthyretin amyloidosis with polyneuropathy (hATTR-PN) and on RNA interference (RNAi) therapeutics in general. This study presents the longest-term data to date on patisiran for hATTR-PN.</p><p><strong>Objective: </strong>To present the long-term efficacy and safety of patisiran in adults with hATTR-PN.</p><p><strong>Design, setting, and participants: </strong>This global open-label extension (OLE) of the APOLLO randomized clinical trial and phase 2 OLE study enrolled patients from 43 hospitals or clinical centers across 19 countries between July 2015 and August 2017, with follow-up until November 2022. Of 212 eligible patients with hATTR who completed the phase 3 APOLLO or phase 2 OLE parent studies, 211 enrolled in and 138 completed the global OLE.</p><p><strong>Intervention: </strong>Patisiran, 0.3 mg/kg, intravenously once every 3 weeks for up to 5 years.</p><p><strong>Main outcomes and measures: </strong>Outcomes evaluated at year 5 of the global OLE included disability (polyneuropathy disability [PND] score); polyneuropathy severity (Neuropathy Impairment Score [NIS]), nutritional status (modified body mass index [mBMI]), quality of life (Norfolk Quality of Life-Diabetic Neuropathy [Norfolk QOL-DN]), and Rasch-Built Overall Disability Scale (R-ODS), with no statistical hierarchy. Safety, survival probability, and mortality were also assessed.</p><p><strong>Results: </strong>At the global OLE baseline, the mean (SD) age was 61.3 (12.3) years, and 156 patients (73.9%) were male. In 138 patients completing the study, PND scores remained stable or improved in 89 patients (65.0%), NISs showed a mean (SD) change of 10.9 (14.7), and mean (SD) mBMI (calculated as weight in kilograms divided by height in meters squared times serum albumin in grams per liter) increased by 46.4 (120.7) over 5 years from baseline. Norfolk QOL-DN and R-ODS scores showed mean (SD) changes of 4.1 (16.7) and -3.7 (6.2), respectively. Adverse events (AEs) leading to study withdrawal occurred in 47 patients (22.3%). Infusion-related reactions were the most common treatment-related AE (n = 34 [16.1%]). Overall, 41 patients (19.4%) died during the study. Patisiran treatment in the parent study and low familial amyloid polyneuropathy score at parent study baseline were associated with significantly improved survival.</p><p><strong>Conclusions and relevance: </strong>In the longest study of an RNAi therapeutic for any disease, patisiran treatment resulted in modest changes for patients with hATTR-PN with an acceptable safety profile. These results highlight the importance of initiating early treatment for hATTR and the potential of RNAi therapeutics in medicine.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02510261.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"228-236"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Effects of MR-Guided Focused Ultrasound Thalamotomy-Time to Evaluation.","authors":"Mickael Aubignat, Olivier Godefroy","doi":"10.1001/jamaneurol.2024.4785","DOIUrl":"10.1001/jamaneurol.2024.4785","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"309"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting Neural Data Privacy-First, Do No Harm.","authors":"Sean Pauzauskie, Jared Genser, Rafael Yuste","doi":"10.1001/jamaneurol.2024.4070","DOIUrl":"10.1001/jamaneurol.2024.4070","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"212-213"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}